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Sexual Activity Screening and Referral to Gynecology Services among Adolescent Women with Chronic Disease in the Pediatric Subspecialty Setting

  • Amy Moore
    Correspondence
    Address correspondence to: Amy Moore, Center for Interdisciplinary Inquiry and Innovation in Sexual and Reproductive Health, University of Chicago, 6030 S. Ellis Ave, Chicago, IL, 60637; Phone (872) 248-9927.
    Affiliations
    Department of Obstetrics and Gynecology, Section of Family Planning and Contraceptive Research, The University of Chicago, Chicago, IL
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  • Amber Truehart
    Affiliations
    Department of Obstetrics and Gynecology, Section of Family Planning and Contraceptive Research, The University of Chicago, Chicago, IL
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  • Isa Alvarez
    Affiliations
    Department of Obstetrics and Gynecology, Section of Family Planning and Contraceptive Research, The University of Chicago, Chicago, IL
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  • Emily Ott
    Affiliations
    Department of Obstetrics and Gynecology, Section of Family Planning and Contraceptive Research, The University of Chicago, Chicago, IL
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  • Kylie Steenbergh
    Affiliations
    Department of Obstetrics and Gynecology, Section of Family Planning and Contraceptive Research, The University of Chicago, Chicago, IL
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  • Hannah Reiser
    Affiliations
    Department of Obstetrics and Gynecology, Section of Family Planning and Contraceptive Research, The University of Chicago, Chicago, IL
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  • Sadia Haider
    Affiliations
    Department of Obstetrics and Gynecology, Section of Family Planning and Contraceptive Research, The University of Chicago, Chicago, IL
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Published:August 17, 2022DOI:https://doi.org/10.1016/j.jpag.2022.08.008

      Abstract

      Study Objective

      Medically complex adolescent girls have significantly increased risk of disease exacerbation from pregnancy, and their use of teratogenic medications poses a risk to a developing fetus. Pediatric subspecialists have an opportunity to screen for sexual activity and refer to gynecology if indicated.

      Methods

      Subspecialist pediatricians (n = 39) completed a survey of their screening and referral practices. A retrospective chart review of a proportion of visits by these providers in the previous 6 months (n = 222) was conducted to compare documented sexual activity, contraception counseling, and referral practices with self-report data.

      Results

      Less than half of providers reported routinely asking about sexual activity (46%), whereas 69% reported routinely referring sexually active adolescents to gynecology. Documentation indicated 11 instances of sexual activity screening (4.9%) and 7 referrals (2.7%).

      Conclusion

      Despite frequent contact with the medical field and use of teratogenic medications, medically complex adolescent girls are inconsistently screened for sexual activity and are rarely referred to gynecology.

      Key Words

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